Bill from Oberlin with a very quick followup
Apr 14, 2008
Thanks so much for answering my first question! So, I took your advice and looked at my risk (fingered a girl) and have calmed down a fair amount since my last post. The one thing that I would say about the fingering is that the cuticle area was sore because it was very red the next morning. The only thing that I could think of is that maybe the skin under my cuticle cracked on underside of cuticle (so beyond the cuticle and between nail and cuticle). Issue is that if it were really cracked and bleeding, then it would have been reopened when I ran hot water over my finger and squeezed it trying to draw blood and I could not draw blood three hours after the incident and I squeezed pretty hard. It also seems likely that even if there was some break it would have been unlikely to have a great enough quantity of fluids to infect given its location.
The symptoms that I had given you before went on for a little longer and I wanted to confirm that these don't suggest or are consistent with ARS (including timeline, etc). Below are the original symptoms:
- Day 32 post exposure (morning have a scratchy throat, light cough but no temperature and feel fine most of day) - Same day around 10pm - fever starts setting in - Day 33 (fever all day ranging from 99.5 - 101.9) - Day 34 around 8am (fever down around normal temp (~98.6 degrees)) Afterwards, experiencing hoarseness - this continued for several more days (laryngitis and lingering cough to clear my throat) Day 35 late evening - cough starts to die down and nasal congestion really starts to increase a bit. The fever returns (although not a high as previous day - mostly low grade) from 10pm on Day 35 and is gone on day 37 when I woke up in the morning (and did not return thereafter). I suffered from a runny nose, congestion and blood in my mucous for the next week after this and really focused on getting my energy back after being sick (took a few days of next week). So, the fever took place over a total of 72 hours if you include both episodes (and no fever since). No other symptoms of rash, etc.
I also had some soft stool during this period of time but only one case of diarrhea.
Around day 45 (little over 6 weeks and a week seperated from other symptoms), I developed night sweats for the next two weeks (on two or three occasions were severe). No other symptoms during this time other than some soft stool. I removed some of the blanketing at night and I sweated much less generally but still sweated (damp t-shirt at times). I had a similar issue two years ago when I was under a lot of stress so this could just be an extension of my anxiety. Also, I could feel my body heating up just as I was falling asleep but when I check my temp I did not have a fever at day or at night after I felt these hot flashes. These episodes lasted on and off for about two weeks. Again, at no time during this period was I running a fever.
This brings me to today. About 9 weeks past the exposure. You mentioned previously that you didn't think that I needed to be tested. Do you still agree with that recommendation? I think that you are going to tell me that this was a non-exposure (which I think that it was) but wanted to get your final thoughts so that I can put this issue to bed finally. I will move on after I hear back from you. Sorry for taking so much of your time. You are truly a God-send and are very generous with your time.
Response from Dr. Frascino
Do I still agree with my previous recommendation? Yes, of course I do! Let's review some of the quotes from my last response to you:
1. "HIV-acquisition risk . . . essentially nonexistent."
2. "Your concerns . . . completely unwarranted."
3. "Your symptoms are not worrisome for or suggestive of HIV ARS."
4. "I see no reason to worry or to get tested."
Bill, I really can't say it any plainer than that! Time to move on from these irrational fears and unwarranted worries. If you write back re-asking the same questions a third time, I'm going to rescind your Oberlin diploma!
Will donate, will do anything, just please HELP Mar 24, 2008
I wanted to know a few things from you. I am really desperate. I know that symptoms do not equal disease but wanted to see if the symptoms sound like ARS or more like common flu / cold (will get to my risk in a moment)
- Day 32 post exposure (morning have a scratchy throat, light cough but no temperature and feel fine most of day) - Same day around 10pm - fever starts setting in - Day 33 (fever all day ranging from 99.5 - 101.9) - Day 34 around 8am (fever down around normal temp (~98.6 degrees)) Afterwards, experiencing hoarseness (laryngitis and lingering cough to clear my throat)
The total time of the fever lasted 30-36 hours max. Didn't have any swollen nodes or rash and throat was not really sore, more hoarseness than anything else with the need to clear my throat a lot. This cough (not completely dry) and hoarseness have lingered now for a day or two post the fever ending.
This seems to me to be a lot like a nasty cold / flu than anything else given the short nature of this. Have you heard of ARS in this form and lasting for 36 hours? My understanding would have been that it would have lasted at least a few days and symptoms would have been concurrent. I understand that symptoms don't equal disease but just wanted to rule out the fact that this wasn't ARS. I think I have OCD.
Now, for my risk:
A) One time incident with a high risk girl (I am a guy)
B) I fingered her for about 10 minutes but did not see any cuts on my fingers. I checked about an hour afterwards and my cuticle was sore but was not able to draw blood or detect any open cuts that would have drawn blood. I also ran hot water over finger in question to see if I could feel any sensitivity and I couldn't detect any open exposures. I would note that the cuticle was a little sore to the touch as it may have been jammed when I was fingering her (was a little aggressive). As an aside, the area that was sore, looked inflamed the next day.
C) After fingering her, she licked my fingers. We then madeout and she then gave me a blowjob for a minute or two. Would there have been a vaginal fluid transfer from her to me then? I have read other things in the archives that indicate that this is not a risk but wanted to ask you again.
I know you get a lot of questions Doc Bob but I beg you to answer my question. I will donate what I can. Can you pls provide the directions to donate? Please help me Doc Bob. I am so desperate right now.
Bill (also an Oberlin grad)
Response from Dr. Frascino
Hello Oberlin Grad Bill,
I'll start with your HIV-acquisition risk. It's essentially nonexistent. Fingering is not considered to be a significant HIV-transmission risk, assuming the skin is intact. Your concern about HIV-infected vaginal fluids being transmitted from her love canal to your probing fingers to her mouth and then finally on to your throbbing tallywhacker is completely unwarranted.
Next, your symptoms are not worrisome for or suggestive of HIV acute retroviral syndrome (ARS).
Finally, I should once again mention the reason to worry or consider getting HIV tested is potential HIV-exposure risk, not the presence or absence of symptoms. So no matter what symptoms you may or may not be experiencing, since you did not have an HIV-exposure risk, I see no reason to worry or to get tested.
Oberlin has now instituted an excellent HIV/AIDS awareness and prevention program. If you were a student there now, you would have known not only the information I presented above, but also much, much more. The HIV/AIDS Awareness and Prevention Program at Oberlin is funded through a grant from the Robert James Frascino AIDS Foundation. Consequently your donation may well help others from having to endure the anxiety you've been experiencing. Donation information for the foundation can be found on the foundation's Web site at www.concertedeffort.org.
Stay safe. Stay well.
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